Manchester rules out maternity closures in short term

Clinicians leading an overhaul of Greater Manchester’s £6bn health economy have ruled out another controversial round of inpatient paediatric and maternity service closures in the short term.

These services could however be later concentrated across a “smaller number of sites” once its on-going ‘Healthier Together’ programme is complete, its business plan indicates.

The programme is being developed by Greater Manchester’s 12 clinical commissioning groups to reshape acute and primary care services across the region to close its £1.1bn funding gap.

The “pre-consultation” business case, published this month, states that closure of inpatient paediatric and maternity units will not feature in the programme’s proposals.

Chris Brookes, medical director of Healthier Together told HSJ the plans would instead focus on bringing paediatric services “closer to home”, ensuring the majority of children were treated in the community rather than in hospitals.

“For us to think about reconfiguration of inpatient paediatric services before we’ve done that first piece of work… would in turns of sequencing be the wrong thing,” he said.

Inpatient maternity services would also be excluded from reconfiguration plans because of its close link to children’s services, Dr Brookes added.

A consolidation of the services might, however, be considered at a later date, he said. “What we do know is that there is an issue with respect to outcomes… [for the] most seriously ill children.

“There’s a variation in outcomes because those children can’t reliably get access to consultant paediatric care, so in the end we think that there will need to be a reshaping of how consultant care is provided across the conurbation”.

While Dr Brookes declined to give a timescale for this later reconfiguration, the implementation of the Healthier Together plans is due to last until the end of 2015,

Under the previous major reshaping of services in 2012, the number of hospitals offering maternity services in Greater Manchester was reduced from 12 to eight.

Healthier Together aimed to create more “single shared services” by encouraging closer working working between trusts, Dr Brookes said. The majority of care would, however, be delivered locally with only a “small number” of high-risk patients travelling further afield for treatment.

“We’ve got evidence around trauma and strokes and primary percutaneous coronary intervention…the smaller number of centres for those very high risk patients… will save a significant number of lives.”

More detail on the Healthier Together plans is expected in June, with a 12-week consultation due to take place in the summer.

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